人文医疗在阴式全子宫切除术联合阴道后壁修补术治疗子宫脱垂合并肠疝患者中的应用

目的探究人文医疗在阴式全子宫切除术联合阴道后壁修补术治疗老年子宫脱垂合并肠疝(阴道后壁膨出)患者中的应用效果。方法选择2018年1月至2019年12月期间天长市中医院收治子宫脱垂合并肠疝患者120例作为研究对象。全部入选病例均行阴式全子宫切除术联合阴道后壁修补术治疗,采用随机数字表法将病例分为对照组和观察组,各60例。对照组给予常规护理,观察组给予人文医疗护理。对比2组患者中文版知觉压力量表(CPSS)评分、抑郁自评量表(SDS)、焦虑自评量表(SAS)评分、心理弹性量表-简表(RS-14)、护理服务满意度、皮质醇(Cor)、心率及平均动脉压。结果护理前,2组CPSS、SDS、SAS及RS-14评分组间比较的差异无统计学意义(P>0.05);护理7 d后,2组CPSS、SDS、SAS及RS-14评分均较护理前降低,且观察组均低于对照组,差异有统计学意义(P<0.05)。观察组患者的满意度(96.67%)较对照组高(80.00%),差异有统计学意义(P<0.05)。观察组手术结束时2组患者的Cor、心率及平均动脉压较对照组低,差异有统计学意义(P<0.05)。结论人文医疗应用于子宫脱垂合并肠疝患者护理中,能够改善其不良情绪,缓解心理压力,减少手术的应激反应,提高患者对护理满意度。     

The relationship between rates of hospitalization for ambulatory care sensitive conditions and local access to primary healthcare in Manitoba First Nations communities: Results from the Innovation in Community-based Primary Healthcare Supporting Transformation in the Health of First Nations in Manitoba (iPHIT) study

ObjectivesThe objective of this study was to assess the performance of models of primary healthcare (PHC) delivered in First Nation and adjacent communities in Manitoba, using hospitalization rates for ambulatory care sensitive conditions (ACSC) as the primary outcome.MethodsWe used generalized estimating equation logistic regression on administrative claims data for 63 First Nations communities from Manitoba (1986–2016) comprising 140,111 people, housed at the Manitoba Centre for Health Policy. We controlled for age, sex, and socio-economic status to describe the relationship between hospitalization rates for ACSC and models of PHC in First Nation communities.ResultsHospitalization rates for acute, chronic, vaccine-preventable, and mental health-related ACSCs have decreased over time in First Nation communities, yet remain significantly higher in First Nations and remote non-First Nations communities as compared with other Manitobans. When comparing different models of care, hospitalization rates were historically higher in communities served by health centres/offices, whether or not supplemented by itinerant medical services. These rates have significantly declined over the past two decades.ConclusionLocal access to a broader complement of PHC services is associated with lower rates of avoidable hospitalization in First Nation communities. The lack of these services in many First Nation communities demonstrates the failure of the current Canadian healthcare system to meet the need of First Nation peoples. Improving access to PHC in all 63 First Nation communities can be expected to result in a reduction in ACSC hospitalization rates and reduce healthcare cost.     

核辐射损伤患者院内护理救治能力量表的编制及信效度检验

目的 编制核辐射损伤患者院内护理救治能力量表,为提高护士的核辐射损伤患者护理能力提供评价依据。方法 采用文献查阅、组织访谈和专家咨询编制量表方法,随机选取某三甲医院330名临床护士作为研究对象,发放量表,进行条目分析及信效度检验。结果 本量表共分为核辐射损伤基础知识、专科装备使用能力、专科病区管理能力、基础护理能力、专科护理能力、自我能力认可6个维度,51个条目。探索性因子分析后,共分为6个主成分,累计解释方差为70.757%。验证性因子分析的χ²、df、χ²/df、CFI、IFI、TLI、NFI、PNFI、PCFI、RMSEA拟合指标均可接受。Cronbach’s α系数为0.976,重测信度为0.823。全体一致S-CVI（S-CVI/UA）为0.84,评价内容效度S-CVI（S-CVI/Ave）为0.98,条目水平内容效度I-CVI为0.78～1.00;结论 本量表的条目及维度设置经检验,各项指标符合要求,信效度检验结果良好,可作为核辐射损伤患者院内护理能力初步评价量表。     

Influenza cases in nine aged care facilities in Sydney,Australia over a three-year surveillance period, 2018—2020

BackgroundInfluenza outbreaks in aged care facilities are a major public health concern. In response to the severe 2017 influenza season in Australia, enhanced influenza vaccines were introduced from 2018 onwards for those over 65 and more emphasis was placed on improving vaccination rates among aged care staff. During the COVID-19 pandemic, these efforts were then further escalated to reduce the additional burden that influenza could pose to facilities.MethodsAn observational epidemiological study was conducted from 2018 to 2020 in nine Sydney (Australia) aged care facilities of the same provider. De-identified vaccination data and physical layout data were collected from participating facility managers from 2018 to 2020. Active surveillance of influenza-like illness was carried out from 2018 to 2020 influenza seasons. Correlation and Poisson regression analyses were carried out to explore the relationship between physical layout variables to occurrence of influenza cases.ResultsInfluenza cases were low in 2018 and 2019, and there were no confirmed influenza cases identified in 2020. Vaccination rates increased among staff by 50.5% and residents by 16.8% over the three-year period of surveillance from 2018 to 2020. For each unit increase in total number of beds, common areas, single rooms, all types of rooms (including double occupancy rooms), the influenza cases increased by 1.02 (95% confidence interval:1.018–1.025), 1.04 (95% confidence interval: 1.019–1.073), 1.03 (95% confidence interval: 1.016–1 0.038) and 1.02 (95% confidence interval:1.005–1.026) times which were found to be statistically significant. For each unit increase in the proportion of shared rooms, influenza cases increased by 1.004 (95% confidence interval:1.0001–1.207) which was found to be statistically significant.ConclusionsThere is a relationship between influenza case counts and aspects of the physical layout such as facility size, and this should be considered in assessing risk of outbreaks in aged care facilities. Increased vaccination rates in staff and COVID-19 prevention and control measures may have eliminated influenza in the studied facilities in 2020.     

Social/sexual awareness of persons with autism: A parental perspective

A parental survey that addressed the social sexual awareness, sex education, and sex behaviors of persons with autism, a developmental disability is provided. Questionnaires from 100 caregivers of persons with autism 9 years of age and older and with the DSM-III-R diagnosis were analyzed. Eighty-five percent of respondents were mothers, 8% both parents, 5% fathers, and 2% others; 32% of the persons with autism were female and 68% male with an age range of 9.1 to 38.9 years. The verbal level of the person with autism related to parents' beliefs about the relevance of sex relations (² = 6.99, p < 0.05) and sex education (² = 22.91, p < 0.001). No relationship between parents' report of the verbal level of the individual and the display of inappropriate sexual behaviors was found (² = 2.56, ns). Parents of males were more concerned about their son being taken advantage of by a same-sex person (² = 15.90, p < 0.001); parents of females were worried about an opposite-sex person (² = 4.06, p < 0.05). Parental concerns and beliefs regarding sexuality varied and could not be generalized. The nonsignificant finding regarding verbal level and display of inappropriate sexual behaviors suggests that the need for sex education is best determined by the behaviors of the person rather than the functioning or verbal levels.     

不同地区妇女产褥期卫生行为研究

目的 了解江苏、陕西和贵州三省妇女产褥期卫生行为和保健的一般情况;比较 不同地区间产褥期各种卫生行为的发生率;了解影响产褥期卫生行为的相关因素。方法 用问卷调查的形式对三者１２个县的２３５２例２岁以下儿童母亲进行入户访问。结果 江苏、陕西、贵州三者产褥期各卫生行为的发和衣次为：洗头２６．４％,３８．８％,１９．８％, 下身（指外阴部,下同）８３．３％,２６．９％,６４．０％,正常活动７６．９％,７     

对护理服务的态度及行为的调查

对该院６４６名护理人员提供护理服务的态度及行为进行了调查,护理人员的护理服务态度及行为得分较高,在满分３０及２４的问题中,平均得分分别为２７６１±２８７分、２１００±２０５分。对影响得分因素做进一步分析发现,护理人员之服务态度得分的高低与婚姻状况、文化程度、技术职称等因素无关;与兼任护理行政职务呈正相关;与年龄呈负相关。护理行为得分与兼职及服务态度呈正相关。对护理工作的看法结果提示,调查对象的赞同率较低,对护理工作看法的得分与护理服务态度及行为呈正相关。提示应重视对护理人员的继续教育及护理观念的转变,使其对护理工作有正确的看法,建立良好的护理服务态度,以促进护理行为向正向发展。     

Quality of life—a measure of the quality of nursing care?

Quality of life is a very complex phenomenon in the life of cancer patients. Individual perceptions might change with the state of disease and with necessary interventions. Some definitions seem to be more useful in cancer care than others. There has been considerable controversy in the quantity versus quality debate. Some confusion in the measurement of quality of life concerns objectivity and subjectivity, referring either to the content of information or to persons other than the patient eliciting it. The relation between quality of life and quality of care has to be further explored: some dimensions of care might be of little or of potential relevance to the patient's quality of life. The dimensions of proven relevance concern psychological well-being through, for example, promotion of self-care or an enhanced perception of self-worth. These findings emphasise the importance of the concept of care, which is the essence of nursing. Contemporary professional and political difficulties require critical analysis.     

呋喃唑酮厌恶疗法戒酒的临床观察及护理

目的：观察呋喃唑酮厌恶疗法戒酒的临床表现，探讨提高戒酒成功率的护理干预措施。方法：对23例酒依赖患者进行呋喃唑酮厌恶疗法，同时加强各阶段的护理干预。结果：一年随访戒酒成功率为87％。结论：患者有戒酒的愿望、家属的积极配合、全面的生活护理及适时的心理暗示是戒酒成功的重要条件。     

钒及其化合物的化学性质和生物学行为

综述了钒的物种变化及其基本化学性质 ,介绍了钒化合物的生物效应和毒理作用机制